The Efficacy Analysis Of Single-nostril Transsphenoidal Endoscopic Pituitary Adenoma Surgery

The efficacy analysis of single-nostril transsphenoidal endoscopic pituitary adenoma surgeryObjective:To explore the indications, contraindications, surgery method, pro-operative, post-operative treatment and efficacy analysis using single-nostril transsphenooidal endoscopic pituitary adenoma surgery; the clinical significance and future perspective of neuroendoscopy in transsphenodial surgery for pituitary adenomas.Methods:The integral clinical date with pituitary adenomas patients surgical treated from department of neurosurgery in the first affiliated hospital Shan Xi medical University, He Ji Affiliated hospital Chang Zhi medical college was analyses retrospectively. The detailed medical records of patients are accessed to and the postoperative follow-up is carried on. The comparing items include the following accepts:the tumor resection rate, the complications after the surgery, including diabetes insipidus, pituitary dysfunction, electrolyte disorders, cerebrospinal fluid rhinorrhea, intracranial infection and nasal hemorrhage. The postoperative length of staying in hospital, the recovery situation of endocrine of PRL and GH, time-length among the operative, clinic symptom improvement, the size of the tumor were analyses. We acquire the conclusion through the statistical analysis.Results:Among this group of 73 cases, total tumor resection are in 47 cases, the subtotal tumor resection,19 cases; the greater tumor resection,5 cases; the part tumor resection,2 cases. The hormone level (according to the pituitary adenoma post-operative biology norm efficacy standard (Hardy)):Cure in 34 cases; improve: 16 cases; invalid:7 cases. The functions of thyroid:improve in 49 cases, no change in 18 cases, worsen 6 cases. Clinical symptoms improvement:cure in 52 cases; improve:35 cases; invalid 5 cases. The complications after the surgery include diabetes insipidus in 19 cases, pituitary dysfunction:6 cases; electrolyte disorders: 14 cases; cerebrospinal fluid rhinorrhea:8 cases; intracranial infection:6 cases; nasal hemorrhage:4 cases; vision decreased 3 cases. The average length of stay in hospital after surgery:10.66±4.94 days, time-length among the operative:2.43±1.41 hours. There was no death case in this group.Conclusions:The endoscopical transsphenodial surgery for pituitary tumors has advantages as minimal invasiveness, clear exposure of operation field, relatively complete resection of tumor, easy to operate, safety for patients, less severe complications, and shorter hospitalization time. The clinical application of the neuroendoscopy for pituitary adenoma is worthy of recommending.